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Pain Reprocessing Therapy for Veterans With Chronic Back Pain: Comparative Efficacy and Facilitators and Barriers to Implementation

Status: Recruiting

Location: See location...

Intervention Type: Behavioral, Other

Study Type: Interventional

Study Phase: Not Applicable

SUMMARY

The goal of this clinical trial is to learn which treatment works better for veterans with chronic neck or back pain. This study is comparing three treatments: Pain Reprocessing Therapy (PRT), Cognitive Behavioral Therapy (CBT), and usual care (whatever a person is already doing to cope with their pain). The main questions the study aims to answer are: 1. Which treatment works better for lowering pain: PRT, CBT, or usual care? 2. How do the effects of PRT compare with CBT and usual care in terms of pain relief and other factors such as emotional functioning, quality of life, anxiety, and pain medication use? Participants will: 1. Be randomly assigned to receive either PRT, CBT, or usual care. 2. Complete questionnaires about their pain and health. 3. If in the PRT or CBT group, have nine weekly therapy sessions over video calls with a therapist.

Eligibility

Participation Requirements

Sex: All

Minimum Age: 18

Healthy Volunteers: f

View:

• Adults (18 and older)

• Be veterans

• Have a history of chronic back or neck pain defined as pain at least half the days of the last 6 months.

• Have moderate or greater pain, defined as pain intensity ≥4 in the past week

Locations

United States

Colorado

VA Eastern Colorado Health Care System

RECRUITING

Aurora

Contact Information

Primary

Jonathan K Ashar, PhD

yoni.ashar.@cuanschutz.edu

303.724.2536

Time Frame

Start Date: 2026-03-27

Estimated Completion Date: 2028-09

Participants

Target number of participants: 360

Treatments

Experimental: Pain reprocessing therapy (PRT)

PRT has 5 components: 1) education about the origin of pain in the brain, its reversibility, and the pain-fear cycle; 2) reinforcing education using personal biography; 3) somatic tracking of pain through mindfulness and reappraisal of pain sensations as non-dangerous; 4) lowering the level of personal threat that may trigger pain sensation; and 5) inducing positive affect in periods of pain. Patients will attend 1 assessment and education telehealth session with a physician followed by 8, 50-minute, therapist-led sessions. Pacing will be weekly for approximately 9 weeks. Treatment will be provided by experienced PRT clinicians. All PRT sessions will be remotely-delivered.

Active_comparator: Cognitive Behavioral Therapy for Chronic Pain (CBT-CP)

CBT-CP, considered the leading psychological treatment for chronic pain, is a structured, time-limited intervention that aims to teach patients how to better manage chronic pain and improve their quality of life. Participants will receive 9, 50-minute sessions of CBT-CP over 9 weeks. The VA CBT-CP protocol contains an initial orientation involving education and familiarization with the CBT-CP approach to chronic pain. The protocol then includes sessions that focus on topics such as exercise, relaxation, pleasant activities, cognitive coping, and sleep. All CBT-CP sessions will be remotely-delivered.

Active_comparator: Usual Care

Participants will be asked to continue whatever they are already doing to care for their back pain. Length of the usual care condition will be 9 weeks, the expected completion time of the PRT and CBT arms.

Related Therapeutic Areas

Chronic Pain

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